Your dog is special! She’s your best friend, companion, and a source of unconditional love. Chances are that you chose her because you like Shih Tzu and you expected her to have certain traits that would fit your lifestyle:

Excellent companion
Needs minimal exercise
Sweet, playful, and friendly
Alert, curious, and busy
Good around other pets and dogs
Intelligent, friendly, and easily won over
However, no dog is perfect! You may have also noticed these characteristics:

An indoor dog that doesn’t do well in the heat
May have a tendency to bark excessively
Can be aggressive, fearful, or snappy if not socialized properly
Can be difficult to housetrain
Fragile and easily injured because of her small size
Needs frequent attention from her family
Is it all worth it? Of course! She’s full of personality, and you love her for it! Her large personality and adorable underbite makes it easy to understand why the Shih Tzu is one of the most popular breeds in the United States.

The “Little Lion Dog” originated in the 17th century in China and is believed to be a cross between the Tibetan Spaniel and the Lhasa Apso. She is a new breed to America: in the 1960s there were only 100 registered in this country! Their popularity rose quickly and they were recognized by the AKC in 1969. They are sensitive to the heat and require only moderate exercise. She is primarily a companion dog, and she takes her job very seriously. Shih Tzu love to be with and on their family whenever possible. The Shih Tzu is a generally healthy breed with an average lifespan of 13-15 years.

Your Shih Tzu’s Health

We know that because you care so much about your dog, you want to take good care of her. That is why we have summarized the health concerns we will be discussing with you over the life of your Shih Tzu. By knowing about health concerns specific to Shih Tzu, we can tailor a preventive health plan to watch for and hopefully prevent some predictable risks.

Many diseases and health conditions are genetic, meaning they are related to your pet’s breed. There is a general consensus among canine genetic researchers and veterinary practitioners that the conditions we’ve described herein have a significant rate of incidence and/or impact in this breed.That does not mean your dog will have these problems; it just means that she is more at risk than other dogs. We will describe the most common issues seen inShih Tzuto give you an idea of what may come up in her future. Of course, we can’t cover every possibility here, so always check with us if you notice any unusual signs or symptoms.

This guide contains general health information important to all canines as well as the most important genetic predispositions for Shih Tzu. This information helps you and us together plan for your pet’s unique medical needs. At the end of the booklet, we have also included a description of what you can do at home to keep your Shih Tzu looking and feeling her best. You will know what to watch for, and we will all feel better knowing that we’re taking the best possible care of your pal.

General Health Information for your Shih Tzu
Dental Disease

Dental disease is the most common chronic problem in pets, affecting 80% of all dogs by age two. And unfortunately, your Shih Tzu is more likely than other dogs to have problems with her teeth. It starts with tartar build-up on the teeth and progresses to infection of the gums and roots of the teeth. If we don’t prevent or treat dental disease, your buddy will lose her teeth and be in danger of damaging her kidneys, liver, heart, and joints. In fact, your Shih Tzu’s life span may be cut short by one to three years! We’ll clean your dog’s teeth regularly and let you know what you can do at home to keep those pearly whites clean.

Infections

Shih Tzu are susceptible to bacterial and viral infections—the same ones that all dogs can get—such as parvo, rabies, and distemper. Many of these infections are preventable through vaccination, which we will recommend based on the diseases we see in our area, herage, and other factors.

Obesity

Obesity can be a significant health problem in Shih Tzu. It is a serious disease that may causeor worsen joint problems, metabolic and digestive disorders, back pain and heart disease. Though it’s tempting to give your pal food when she looks at you with those soulful eyes, you can “love her to death” with leftover people food and doggie treats. Instead, give her a hug, brush her fur or teeth, play a game with her, or perhaps take her for a walk. She’ll feel better, and so will you!
Parasites

All kinds of worms and bugs can invade your Shih Tzu’s body, inside and out. Everything from fleas and ticks to ear mites can infest herskin and ears. Hookworms, roundworms, heartworms, and whipworms can get into hersystem in a number of ways: drinking unclean water, walking on contaminated soil, or being bitten by an infected mosquito. Some of these parasites can be transmitted to you or a family member and are a serious concern for everyone. For your canine friend, these parasites can cause pain, discomfort, and even death, so it’s important that we test for them on a regular basis. We’ll also recommend preventive medication as necessary to keep her healthy.

Spay or Neuter

One of the best things you can do for your Shih Tzu is to have her spayed (neutered for males). In females, this means we surgically remove the ovaries and usually the uterus, and in males, it means we surgically remove the testicles. Spaying or neutering decreases the likelihood of certain types of cancers and eliminates the possibility of your pet becoming pregnant or fathering unwanted puppies. Performing this surgery also gives us a chance, while your pet is under anesthesia, to identify and address some of the diseases your dog is likely to develop. For example, if your pet needs hip X-rays or a puppy tooth extracted, this would be a good time. This is convenient for you and easy for your friend. Routine blood testing prior to surgery also helps us to identify and take precautions for common problems that increase anesthetic or surgical risk. Don’t worry; we’ll discuss the specific problems we will be looking for when the time arrives.

Genetic Predispositions for Shih Tzu

Liver Problems

Your Shih Tzu is more likely than other dogs to have a liver disorder called portosystemic shunt (PSS). Some of the blood supply that should go to the liver goes around it instead, depriving the liver of the blood flow it needs to grow and function properly. If your friend has PSS, his liver cannot remove toxins from his bloodstream effectively. To check for this problem, we’ll conduct a liver function test in addition to a standard pre-anesthetic panel every time he undergoes anesthesia. If he develops symptoms such as stunted growth or seizures, we’ll test his blood and possibly conduct an ultrasound scan of his liver. Surgery may be needed, but in some cases, we can treat with a special diet and medication.

Bone and Joint Problems

A number of different musculoskeletal problems have been reported in Shih Tzu. While it may seem overwhelming, each condition can be diagnosed and treated to prevent undue pain and suffering. With diligent observation at home and knowledge about the diseases that may affect your friend’s bones, joints, or muscles you will be able to take great care of him throughout his life.
Sometimes your Shih Tzu’s kneecap (patella) may slip out of place (called patellar luxation). You might notice that he runs along and suddenly picks up a back leg and skips or hops for a few strides. Then he kicks his leg out sideways to pop the kneecap back in place, and he’s fine again. If the problem is mild and involves only one leg, your friend may not require much treatment beyond arthritis medication. When symptoms are severe, surgery may be needed to realign the kneecap to keep it from popping out of place.

You’ve probably heard of hip dysplasia, an inherited disease that causes the hip joints to form improperly and leads to arthritis: it is common in Shih Tzu. You may notice that he has lameness in his hind legs or has difficulty getting up from lying down. We can treat the arthritis — the sooner the better — to avoid discomfort and pain. We’ll take X-rays of your dog’s joints to identify the disease as early as possible. Surgery is sometimes considered in severe and life-limiting cases of hip dysplasia. Keep in mind that overweight dogs may develop arthritis years earlier than those of normal weight, causing undue pain and suffering.
Spine Problems

Intervertebral disc disease (IVDD ) is a common condition in Shih Tzu. The disease is caused when the jelly-like cushion between one or more vertebrae slips or ruptures, causing the disc to press on the spinal cord. If your dog is suddenly unable or unwilling to jump up, go up stairs, is reluctant to move around, has a hunched back, cries out, or refuses to eat or go potty, he is likely in severe pain. He may even drag his back feet or be suddenly paralyzed and unable to get up or use his back legs. If you see symptoms, don’t wait. Call us or an emergency clinic immediately! For less severe cases, rest and medication may resolve the problem. In many cases involving paralysis, we’ll recommend surgical removal of the ruptured discs (within 24 hours of the onset of symptoms to get the best results). As with so many other diseases, weight control helps to prevent this problem. You should also use ramps or steps from puppyhood on so that your dog doesn’t spend a lifetime stressing his back by jumping on and off of the furniture.

Eye Problems

Not many things have as dramatic an impact on your dog’s quality of life as the proper functioning of his eyes. Unfortunately, Shih Tzu can inherit or develop a number of different eye conditions, some of which may cause blindness if not treated right away, and most of which can be extremely painful! We will evaluate his eyes at every examination to look for any signs of concern.

Because your Shih Tzu has eyeballs that naturally protrude, he is more vulnerable to eye injuries. Scrapes or punctures to the cornea (the protective covering on the eyeball) are the most common injuries. Not only do they hurt, they can become infected and affect his vision. Don’t let him ride in the car with his head out the window as this is a frequent cause of eye injuries. Call us right away if he has any problems with his eyes. A damaged cornea is painful and should be treated immediately. Medication and sometimes surgery is required.

Glaucoma, an eye condition that affects Shih Tzu and people too, is an extremely painful disease that rapidly leads to blindness if left untreated. Symptoms include squinting, watery eyes, bluing of the cornea (the clear front part of the eye), and redness in the whites of the eyes. Pain is rarely noticed by pet owners though it is frequently there and can be severe. People who have certain types of glaucoma often report it feels like being stabbed in the eye with an ice pick! Yikes! In advanced cases, the eye may look enlarged or swollen like it’s bulging. We’ll perform his annual glaucoma screening to diagnose and start treatment as early as possible. Glaucoma is a medical emergency. If you see symptoms, don’t wait to call us, go to an emergency clinic!

Dry eye, also known as keratoconjunctivitis sicca or KCS, is common in Shih Tzu. The tear glands no longer produce enough tears to keep the eye moist, which results in sore, itchy eyes and infections. Ouch! Symptoms include a thick discharge, squinting, pawing at the eye, or a dull, dry appearance of the eye. This is a painful condition; please call us immediately if you notice any of these signs. We’ll conduct a tear test when we examine him. If he has this disease, we’ll prescribe ointment that you’ll need to apply for the rest of your dog’s life.
Cataracts are a common cause of blindness in older Shih Tzu. We’ll watch for the lenses of his eyes to become more opaque—meaning they look cloudy instead of clear—when we examine him. Many dogs adjust well to losing their vision and get along just fine. Surgery to remove cataracts and restore sight may also be an option.

Kidney Disease

Glomerulonephropathy is an inherited disease that slowly damages your Shih Tzu’s kidneys causing them to fail, often at an early age. Because damaged kidneys leak protein, we may be able to diagnose this disease by testing his urine for excessive protein. We recommend yearly urine analysis because early detection leads to a happier pet and an easier, more affordable treatment plan. We may also recommend a special diet as part of the therapy plan.

Bladder or Kidney Stones

There are a few different types of stones that can form in the kidney or in the bladder, and Shih Tzu are more likely to develop them than other breeds. We’ll periodically test his urine for telltale signs indicating the presence of kidney and bladder stones; they are painful! If your buddy has blood in his urine, can’t urinate, or is straining to urinate, it is a medical emergency. Call us immediately!
Hyperadrenocorticism (Cushing’s )

Cushing’s Disease is a malfunction of the adrenal glands causing them to produce too much steroid hormone. This is a common problem in dogs, and your Shih Tzu is more likely than other dogs to be affected. The condition usually develops slowly, and the early signs are easily missed. Symptoms include drinking and urinating more than normal, increased appetite and reduced activity level. Later, a potbelly, thin skin, and hair loss are characteristic. Treatment usually includes oral medications, and requires close coordination with us to ensure correct dosing.
Cancer

Cancer is a leading cause of death in older dogs. Your Shih Tzu will likely live longer than many other breeds and therefore is more prone to get cancer in his golden years. Many cancers are cured by surgically removing them, and some types are treatable with chemotherapy. Early detection is critical! We’ll perform periodic diagnostic tests and look for lumps and bumps when we examine your pet.

Allergies

In humans, an allergy to pollen, mold, or dust makes people sneeze and their eyes itch. In dogs, rather than sneeze, allergies make their skin itchy. We call this skin allergy “atopy”, and Shih Tzu often have it. Commonly, the feet, belly, folds of the skin, and ears are most affected. Symptoms typically start between the ages of one and three and can get worse every year. Licking the paws, rubbing the face, and frequent ear infections are the most common signs. The good news is that there are many treatment options available for this condition.

Allergies, swimming, overgrowth of hair in the ear canals, or an accumulation of earwax can all predispose your dog to ear infections, which are painful and annoying. Shih Tzu are very often afflicted by allergies, which cause itching and inflammation in the ears and elsewhere. The earlier we diagnose this disease, the less discomfort and pain he will suffer. Be sure to call us if you notice him scratching or shaking his head, a foul odor from the ears, or if his ears seem painful to the touch. By monitoring for ear infections and treating them early, we also reduce the likelihood of eardrum damage that can lead to deafness. Most ear infections tend to recur until we work together to control the underlying cause.

Bleeding Disorders

There are several types of inherited bleeding disorders which occur in dogs. They range in severity from very mild to very severe. Many times a pet seems normal until a serious injury occurs or surgery is performed, and then severe bleeding can result. Von Willebrand’s disease is a blood clotting disorder frequently found in Shih Tzu. We’ll conduct diagnostic testing for blood clotting time or a specific DNA blood test for Von Willebrand’s disease or other similar disorders to check for this problem before we perform surgery.

Heart Disease

Shih Tzu are prone to multiple types of heart disease, which can occur both early and later in life. We’ll listen for heart murmurs and abnormal heart rhythms when we examine your pet. When indicated, we’ll perform an annual heart health check, which may include X-rays, an ECG, or an echocardiogram, depending on your dog’s risk factors. Early detection of heart disease often allows us to treat with medication that usually prolongs your pet’s life for many years. Veterinary dental care and weight control go a long way in preventing heart disease.

Respiratory Distress Syndrome

This disease, also known as brachycephalic syndrome, affects dogs with a short nose, like your Shih Tzu. He has the same amount of tissue in his nose and throat as the longer-nosed dogs, but there’s no place for it to go. As a consequence, the soft palate (the soft part at the back of the roof of the mouth), is too long and hangs down into the airway. The nostrils are often too small, and sometimes the trachea, or windpipe, is narrow and undersized. All of these things lead to a narrow and obstructed airway. Many of these dogs can barely breathe! Watch for exercise intolerance, loud breathing, coughing, bluish gums, or fainting. With his short nose, he is also more likely to develop other problems, such as flatulence from excessive air intake, pneumonia from aspirating food, or heat stroke. In severe cases, surgical correction may be recommended.

Dental Abnormalities

Teeth abnormalities are often genetically induced and are relatively common in dogs, especially in purebred dogs like your Shih Tzu. An overbite or underbite is called a malocclusion, or a bad bite. Oligodontia is a condition where only a few teeth are present. Misaligned teeth can also occur and cause lots of problems, but can usually be corrected with braces or extractions. (Yes, dogs can get braces!) We want to keep your buddy’s teeth healthy so we will be watching his developing teeth closely.
Taking Care of Your Shih Tzu at Home

Much of what you can do to keep your dog happy and healthy is common sense, just like it is for people. Watch her diet, make sure she gets plenty of exercise, regularly brush her teeth and coat, and call us or a pet emergency hospital when something seems unusual (see “What to Watch For” below). Be sure to adhere to the schedule of examinations and vaccinations that we recommend for her. This is when we’ll give her the necessary “check-ups” and test for diseases and conditions that are common in Shih Tzu. Another very important step in caring for your pet is signing up for pet health insurance. There will certainly be medical tests and procedures she will need throughout her life and pet health insurance will help you cover those costs.

Routine Care, Diet, and Exercise

Build her routine care into your schedule to help your Shih Tzu live longer, stay healthier, and be happier during her lifetime. We cannot overemphasize the importance of a proper diet and exercise routine.

Supervise your pet as you would a toddler. Keep doors closed, pick up after yourself, and block off rooms as necessary. This will keep her out of trouble and away from objects she shouldn’t put in her mouth.
Regular brushing and grooming is needed to keep her coat beautiful.
Shih Tzu often have serious problems with their teeth, so you’ll need to brush them at least three times a week!
Clean her ears weekly, even as a puppy. Don’t worry—we’ll show you how!
She is well suited for apartment living; she will need a daily walk and regular inside play.
She can be sensitive to warm temperatures; avoid any prolonged exposure and be very alert to the signs of heat stress.
She is highly intelligent and can be taught to perform a variety of tricks to keep her mentally stimulated.
Keep your dog’s diet consistent and don’t give her people food.
Feed a high-quality diet appropriate for her age.
Exercise your dog regularly, but don’t overdo it at first.
What to Watch For

Any abnormal symptom could be a sign of serious disease, or it could just be a minor or temporary problem. The important thing is to be able to tell when to seek veterinary help, and how urgently. Many diseases cause dogs to have a characteristic combination of symptoms, which together can be a clear signal that your Shih Tzu needs help.

Office calls

Give us a call for an appointment if you notice any of these types of signs:

Change in appetite or water consumption
Tartar build-up, bad breath, red gums, or broken teeth
Itchy skin (scratching, chewing, or licking), hair loss
Lethargy, mental dullness, or excessive sleeping
Fearfulness, aggression, or other behavioral changes
Lumps or bumps – regardless of size
Emergencies

Seek medical care immediately if you notice any of these types of signs:

Scratching or shaking the head, tender ears, or ear discharge
Inability or straining to urinate; discolored urine
Cloudiness, redness, itching, or any other abnormality involving the eyes
Slow or stunted growth; sometimes seizures after eating
Drinks and urinates more, eats more, potbelly, poor haircoat
Coughing, exercise intolerance, rapid breathing at rest
Loud breathing, tires easily at exercise
Leg stiffness, reluctance to rise, sit, use stairs, run, jump, or “bunny hopping”
Partners in Health Care

DNA testing is a rapidly advancing field with new tests constantly emerging to help in the diagnosis of inherited diseases before they can become a problem for your friend. For the most up-to-date information on DNA and other screening tests available for your pal, visit www.Genesis4Pets.com.

Your Shih Tzu counts on you to take good care of her, and we look forward to working with you to ensure that she lives a long and healthy life. Our goal is to provide the best health care possible: health care that’s based on her breed, lifestyle, and age. Please contact us when you have questions or concerns.

References:

Ackerman L. The Genetic Connection: A Guide to Health Problems in Purebred Dogs. Second edition. AAHA Press; 2011.
Bell JS, Cavanagh KE, Tilley LP, Smith FW. Veterinary medical guide to dog and cat breeds. Jackson, Wyoming. Teton New Media; 2012.
Gough A, Thomas A. Breed Predispositions to Disease in Dogs and Cats. 2nd Edition. Wiley-Blackwell; 2010.
Crook A, Dawson S, Cote E, MacDonald S, Berry J. Canine Inherited Disorders Database [Internet]. University of Prince Edward Island. 2011. [cited 2013 May 21]. Available from: http://ic.upei.ca/cidd/breed/shih-tzu
Breed Specific Health Concerns [Internet]. American Kennel Club Canine Health Foundation, Inc. [cited 2013 May 21]. Available from: http://www.akcchf.org/canine-health/breed-specific-concerns/?breed=shih-tzu